Fontan Circulation, Single-ventricle
Conditions
Keywords
Venous Compression, Exercise Testing, Cardiac Reserve, Fontan Circulation, Magnetic Resonance Imaging, vascular function
Brief summary
The aim of this study is to investigate whether venous compression garments increase exercise stroke volume in patients with Fontan circulation. To address this aim, we will test the following hypotheses: 1. Acute and chronic external venous compression will increase exercise stroke volume in patients with Fontan circulation. 2. Patients with significant venous varicosities will have a greater response to venous compression. Participants will: * Undergo submaximal exercise testing in MRI to measure venous return and exercise stroke volume with and without the wearing of compression garments * Undergo submaximal exercise testing on a seated upright exercise ergometer with concurrent measurement of stroke volume with and without the wearing of compression garments * A subset of participants will repeat both testing visits after wearing compression garments for 2-weeks during waking hours. Participants will: * Undergo submaximal exercise testing in MRI to measure venous return and exercise stroke volume with and without the wearing of compression garments * Undergo submaximal exercise testing on a seated upright exercise ergometer with concurrent measurement of stroke volume with and without the wearing of compression garments * A subset of participants will repeat both testing visits after wearing compression garments for 2-weeks during waking hours.
Detailed description
Study Day 1 - Consent, Screening and Garment Measurements: Following assessment of participant eligibility, all participants will undergo leg venous ultrasound assessment and abdominal-foot measurements for the custom making of compression garments. Study Day 2 - MRI: Study participants will undergo comprehensive cardiovascular MRI using a 3T MRI scanner with and without compression garments and exercise. Study Day 3 - Cardiovascular & Exercise Testing Day: All participants will undergo comprehensive cardiovascular structure and function assessments at rest and during exercise with and without the wearing of compression garments. Baseline testing will include dual x-ray absorptiometry (DEXA), pulmonary function testing, comprensive vascular assessments and echocardiography. During exercise at two submaximal workloads, the study team will measure blood pressure, oxygen uptake and cardiac output.
Interventions
Acute and 2-week effects of compression garments
OTHERWithout compression garments
Acute effects without compression garments
Sponsors
University of Texas Southwestern Medical Center
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
Patients with a Fontan circulation - Inclusion criteria: • Patients at UTSW aged 18-45 years old with a Fontan circulation.
Exclusion criteria
* NYHA Class 4 * Severe AV valve regurgitation * Severe ventricular dysfunction * Large ascites * Significant varicosities * Atrio-pulmonary (AP) Fontan * Known Fontan thrombus * Poorly controlled arrythmia * Unplanned cardiac admission in the last 6 months * Cyanosis (resting O2 saturation \<85%) * Pregnant * Common femoral vein obstruction \>50% to be performed following completion of informed consent. Healthy Controls: Healthy control participants will be recruited on the basis of having no known chronic diseases and not currently taking any cardiovascular medications.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Stroke Volume with Exercise | Rest (20 minutes), Exercise (10 minutes) | The change in single ventricular stroke volume from rest to moderate intensity exercise with compression garments during baseline testing |
| The Acute Effect of Compression Garments on Stroke Volume during Exercise | Rest (20 minutes) and Exercise (10 minutes) repeated during baseline testing | The difference in the change in single ventricular stroke volume during moderate intensity exercise between baseline testing with (outcome #1) and without (outcome #2) garments |
| The Chronic Effect of Compression Garments on Stroke Volume during exercise | Rest (20 minutes) and Exercise (10 minutes) completed during baseline and during follow-up testing | The difference in the change in single ventricular stroke volume during moderate intensity exercise between baseline testing without garments (outcome #2) and following 2 weeks of wearing compression garments (outcome #3) in patients with Fontan Circulation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Venous Return with Exercise | Rest (10 minutes) and Exercise (5 minutes) | The change in inferior vena cava flow from rest to moderate intensity exercise with compression garments using MRI during baseline testing |
| The Acute Effect of Compression Garments on Changes in Venous Return with Exercise | Rest (10 minutes) and Exercise (5 minutes) repeated during baseline testing | The difference in the change in inferior vena cava flow during moderate intensity exercise between baseline testing with (outcome #6) and without (outcome #7) garments |
| The Chronic Effect of Compression Garments on Changes in Venous Return with Exercise | Rest (10 minutes) and Exercise (5 minutes) completed during baseline and during follow-up testing | The difference in the change in inferior vena cava flow during moderate intensity exercise between baseline testing without garments (outcome #7) and following 2 weeks of wearing compression garments (outcome #8) in patients with Fontan Circulation. |
Countries
United States
Contacts
CONTACTKeri Shafer, MD
CONTACTDenis J Wakeham, PhD
PRINCIPAL_INVESTIGATORKeri Shafer, MD
University of Texas Southwestern Medical Center
Outcome results
None listed